What operations to remove varicose veins are the most effective

The removal of veins in the lower extremities is known as radical methods of treatment. The patient may be prescribed an operation to remove varicose veins on the legs if the use of conservative and alternative methods of therapy does not have adequate therapeutic effect and the disease continues to progress.

With the advanced form of varicose veins, surgery can solve the following problems:

• Eliminate pathological reflux (reverse flow) of blood.
• Save healthy, disease-free sections of the saphenous veins.
• Remove the affected areas of the veins.

Before the operation, the doctor marks the veins under ultrasound control, which allows him to determine the extent of the affected segment. Removal of the affected vessels and sections of the vein is carried out using a narrow probe, which is inserted through a small incision. After the affected area is removed, the risk of disease recurrence is low.

After surgery to remove a varicose vein, the chance of recurrence of the disease is low.

In modern medicine, they prefer the combined phlebectomy procedure, which involves the use of several techniques at once.

The main stages of combined radical treatment are: upper or lower crossectomy, short stripping, ligation of perforating veins, miniphlebectomy.

In the initial stages of the disease, any of the listed procedures can be used as an independent operation. In some cases, as an alternative to some stages of classical combined phlebectomy, minimally invasive treatment methods in the form of sclerotherapy or laser obliteration may be offered.

Types of operations

The general name for the operation to remove the affected veins is phlebectomy. Modern types of this procedure:

• The implementation of the stripping procedure (long or short) is the most gentle technique, during which the doctor can remove only a certain part of the affected vein. The procedure is done through a small incision along the vein.
• The application of laser phlebectomy is a modern method of treatment that involves the use of a laser. Thanks to this tool, the laser coagulation process takes place inside the affected vessels. The procedure is performed under local anesthesia and does not require the use of special surgical instruments. The laser is injected into the vein along with a catheter of small diameter, then under the influence of the pulse small vapor bubbles are formed that affect the walls of the vessels. As a result, the affected vein becomes part of the tissue and no longer bothers the patient.
• Endoscopic excision of the affected vein. In this case, an endoscope is inserted into the area of the vein, and the doctor can personally analyze its condition and degree of damage. In the future, the surgeon has the opportunity to cut out the affected area.

So-called seamless technologies are very popular, when the affected area of the vein is removed through small pinpoint incisions. Already 4-6 hours after the manipulation, the patient can walk independently. In the event that the development of trophic disorders is observed, endoscopic equipment is used.

The advantage of the miniphlebectomy method.

Miniphlebectomy is one of the most painless and non-traumatic methods of surgical removal of affected veins. The procedure is carried out in three stages: diagnosis, a small incision with a scalpel at the site of impaired blood flow, removal of the affected area from the vein.

The operation is performed under local anesthesia, the rehabilitation period does not require much time from the patient. Scars, hematomas do not form at the puncture site, pain is disturbed in isolated cases.

Miniphlebectomy is an almost painless way to get rid of varicose veins, the recovery period after the operation is minimal.

To minimize the risk of bruising and bruising, the operation can be performed under tumescent anesthesia, which, in addition to anesthetic, includes a substance that has a vasoconstrictor effect. After the procedure, the patient is discharged within a few hours, as long as the characteristic intoxication of general anesthesia, as well as the pain, do not occur.

crossectomy

The concept of "crossectomy" means ligation and subsequent crossing of a small or large saphenous vein. As an independent operation, such a procedure can only be carried out in emergency cases, when there is a risk of spreading an acute form of thrombosis.

To date, there are gentler alternative procedures for crossectomy: performing endovasal laser ablation and radiofrequency ablation.

The advantages of the techniques are: the possibility of refusing general anesthesia, outpatient treatment, the absence of cosmetic defects in the form of scars from incisions and scars.

Among the minuses, an increased probability of recurrence of the disease and a fairly high cost of these procedures can be noted.

Training

The operation for varicose veins of the lower extremities is carried out after a preliminary examination of the patient and the implementation of an internal examination.

The following types of exams can be assigned:

• Ultrasound of the veins of the legs.
• General blood tests.

In the future, the doctor will conduct an oral survey to identify possible contraindications to surgical intervention. A preliminary examination allows you to choose the optimal type of surgical procedure or, if necessary, to combine several known methods at once.

It is very important that the patient understands how to behave correctly before and after the procedure. Before surgery, it is recommended to refrain from taking medications, including aspirin, due to the risk of bleeding. On the day of the operation, it is not necessary to prepare for the procedure especially carefully; you just need to get rid of the hair in the area of the operated limb.

When is an operation needed?

Patients wondering whether surgery is needed for varicose veins of the lower extremities should understand that such a radical method of therapy is necessary in the following cases:

• The rapid progression of the disease, which is accompanied by severe pain.
• The development of varicose thrombophlebitis of 1-4 degrees.
• Sensation of intense heat and burning in the region of the veins.
• The spread of varicose veins above the kneecaps.
• Visible formation of a swollen vein, aesthetically unattractive.

The operation is also indicated for the formation of long-term non-healing trophic disorders (ulcers), for which conservative therapy does not have adequate therapeutic effect.

Contraindications and possible consequences

It is mandatory to take into account possible contraindications and consequences of surgical intervention.

Surgical intervention cannot be performed if the patient has a history of such diseases as hypertension, heart rhythm disturbances, coronary heart disease, the presence of infectious diseases in the acute stage, inflammatory dermatological diseases in the legs.

The operation should not be performed in late pregnancy, as well as in elderly patients with weakened immunity.

Patients should take into account possible complications, as well as the consequences of surgical intervention:

• Violation of the sensitivity of the operated limb as a result of damage to the nerve endings.
• Intermittent or persistent numbness in the ankle area.
• The formation of suppuration.
• The development of bleeding of variable intensity.
• Re-education of bulging veins in a place above or below the postoperative scars.
• Pain syndrome does not bother all patients and occurs if the nerve endings have been affected. Normalization of sensitivity in most cases occurs independently, without the use of any drugs.
• Bruising and bruising at the surgical site can be bothersome. In this case, drugs from the group of anticoagulants for topical use can be prescribed. If the patient has very delicate and sensitive skin, traces of bruising may persist for 1-1. 5 months.
• The development of edema may indicate that the patient does not follow the doctor's instructions, does not observe the rest regimen, and exposes the body, including the lower extremities, to excessive physical exertion.

Strictly follow the doctor's recommendations, it depends on how soon the consequences of the operation will pass.

Therefore, before deciding whether it is worth having surgery for varicose veins, you should take into account all possible risk factors - thoroughly weigh the pros and cons. The operation should be performed in cases where the manifestations of the disease bother patients for a long time and significantly worsen the quality of life.

It is also necessary to consult only experienced and qualified doctors who perform such operations - phlebologists, angiosurgeons.

Recovery period

After the operation, the patient is recommended to follow all the instructions of the attending physician so that the recovery period lasts as short as possible and he can quickly return to his usual lifestyle. During the first 48 hours, patients are strictly prohibited from:

• The use of alcoholic beverages.
• Management of motor transport.
• Bathe in a Jacuzzi.
• Excessive physical activity.

In the first days after the operation, there may be complaints of pain in the legs, as well as an increase in body temperature. In this case, it concerns medical methods of therapy, physiotherapy is prescribed. The patient should not always be in a horizontal position. He must walk a little every day to restore blood flow.

In the future, the implementation of the following recommendations also minimizes the risk of developing these postoperative complications.

1. Hydroprocedures, massages, therapeutic exercises and other physiotherapy methods, which will be prescribed by the treating physician. Such procedures prevent the formation of blood clots, normalize the outflow of blood.
2. During the first few months, both limbs will need to be rewound in special elastic underwear or compression stockings.
3. Use drugs from the group of phlebotonics, angioprotectors. With the development of inflammatory processes, antibacterial drugs can be prescribed. Analgesics are used to relieve pain.
4. In the event that sutures have been applied, they can be removed 7 days after the intervention.
5. If the patient is overweight, then he must be brought back to normal in order to reduce the load on the veins.
6. It is recommended to give preference to loose clothing made of natural fabrics and comfortable shoes. The use of high heels is contraindicated.
7. At home, you should try to keep your legs elevated using rollers or pillows.

The rehabilitation period can last several weeks, during which the patient will receive special sick leave.

Modern methods of removing varicose veins involve a rehabilitation period of only a few days, but are more expensive than usual.

In the future, the patient must come for a second examination and undergo an additional examination for the doctor to assess the effectiveness of the treatment.

Cost of operation

Phlebectomy is performed both in public clinics and in plastic surgery centers, whose purpose is to eliminate aesthetic imperfections.

Patients are interested in how much varicose vein surgery costs.

It all depends on the clinic and the qualifications of the doctor performing the procedure, as well as the degree of development of the disease and the complexity of the proposed operation. The last place in the formation of prices is not given to the city and region in which the patient intends to perform the procedure.

Several clinics include a preoperative exam as well as a rehabilitation period, due to cost.

Expert forecasts

The implementation of the combined phlebectomy procedure does not exclude the possibility of a recurrence of the disease. After the use of radical methods of treatment, the recurrence of varicose veins is possible due to the physiological characteristics of the body (the structure of blood vessels and veins), or a violation of the technique for performing the procedure (if the doctor could not normalize the patency of the affected vein). The risk of exacerbation of the disease is observed in approximately 15-20% of cases. In the event that the patient observes manifestations of a repeated relapse of the disease, he should consult a doctor as soon as possible.

Only an experienced specialist will help you correctly suggest which operation to choose to remove varicose veins, as well as give useful recommendations that will need to be followed during the recovery period. If you do not consult a doctor in a timely manner, the consequences can be the most deplorable and irreversible.